The World’s Oldest Mother–Too Old?

The case of Adriana Iliescu made headlines around the world when the 66-year-old woman gave birth to a baby girl. Doctors at Romania’s Giulesti Maternity Hospital announced the birth on January 16, 2005, declaring Ms. Iliescu to be the world’s oldest mother.

The announcement immediately incited controversy around the world, with many observers quickly calculating that this mother will be 82 when her daughter is 16.

As usual, there is much more to this story than the initial press reports indicated. Adriana Iliescu is a retired history professor and author of children’s books who had sought hormonal treatments for nine years, attempting to delay the onset of menopause. Later, she approached medical authorities about her desire for an IVF [in vitro fertilization] treatment in order to bear a child. She found a willing clinic and announced her decision in an interview published last December. The announcement by her doctors informed the world that Ms. Iliescu had given birth to a three pound one ounce baby girl, promptly named “Eliza Maria.”

The case of Adriana Iliescu’s baby raises a host of questions about new reproductive technologies, personal autonomy, and the “right” of individuals to demand access to advanced fertility technologies.

According to Ms. Iliescu, she simply couldn’t stand the thought that she would die without giving birth to a child. As a matter of fact, she claims an absolute right to bear a child, regardless of other considerations. “I believed all my life that a woman has a right to give birth and that is why I had to follow my dream, no matter how old I was,” Iliescu told the press.

Her doctors also defended the use of IVF technology in this case. “She was in the right condition to carry a pregnancy,” said Dr. Bogdan Marinescu, chief of the Giulesti Maternity Hospital in Bucharest. “From a biological point of view, Ms. Iliescu proved that she can carry a pregnancy to the end,” he said. “We managed to solve a case which made us all very nervous.”

That state of nervousness extends far beyond Ms. Iliescu’s medical team. In the first place, the most sensational element of this case is the age of the mother. In subsequent interviews, Ms. Iliescu admitted to having secured two abortions earlier in life, during normal childbearing years. “I got married when I was only 20–still a student,” she explained. “My husband was also still a student at the Atomic Physics University back then, and the marriage didn’t last long. We divorced four years later.” She went on to explain, “In that time I had two pregnancy terminations–it was the normal thing back then and the accepted form of contraception. If there’s anything I regret then it is those terminations, not having a baby now. Religion was not a big part of many people’s lives, and I had never had any religious education. I believed the party line that a fetus is only considered life when it is older than three months. In those days I would never have thought of a termination as murder, as I do now.”

Ms. Iliescu’s radical change of mind on the question of abortion is to be applauded and welcomed. In the years after her marriage dissolved, she became an active participant in the Romanian Orthodox Church, and came to believe that all human life is sacred. In some sense, this apparently fueled her desire for a child of her own.

Nevertheless, regardless of Ms. Iliescu’s pro-life convictions, her demand for and use of IVF technology in this case violates a comprehensive pro-life worldview. IVF technology is problematic in any case, but the moral problems escalate when donor gametes (eggs or sperm) are used in the IVF process, or when not all of the fertilized eggs are transferred to the woman’s uterus. In other words, the use of donor sperm or eggs complicates the situation from one perspective, while at the same time, the creation of fertilized eggs that will remain in the laboratory or be destroyed also violates the sanctity of human life.

In Ms. Iliescu’s case, we face the reality that an unmarried 66-year-old woman sought to bear a child using IVF technology. Initial press reports indicated that Ms. Iliescu achieved pregnancy with the use of donor sperm and artificial insemination. Later press reports clarified that both the eggs and the sperm used in this case were donated “from healthy young people.” This caught the attention of Wired.com, a technologically savvy Web site that is inclined to promote just about any technology and demonstrates a rather libertarian worldview. “What is often overlooked in stories like Adriana Iliescu’s is the fact that the woman’s own eggs were not used in the procedure,” the site noted. “Both the eggs and the sperm used were donated. Iliescu was essentially a surrogate for strangers’ DNA.”

After the medical authorities celebrated Eliza Maria’s birth, they also clarified that the birth came by Caesarean procedure in the 33rd week of Ms. Iliescu’s pregnancy. Furthermore, the Caesarean procedure gave birth to two babies, but one was stillborn. Later, doctors acknowledged that a third baby had died by miscarriage during her pregnancy. All together, this means that Eliza Maria was the only surviving baby of a three-baby pregnancy produced by IVF technology.

Arthur Caplan, director of the Center for Bioethics at the University of Pennsylvania, argued that Ms. Iliescu’s case did indeed lead to a pregnancy, but was not the case of “a woman giving birth to a biological [that is, biologically related] child.” Caplan insisted that a further question must be asked: “Why would anyone put a 66-year-old woman through pregnancy?”

Several medical authorities agreed, and questioned the entire procedure based not only on the risk to the babies, but to Ms. Iliescu herself. Put simply, a 66-year-old woman is not in prime physical condition for pregnancy.

Medical authorities believe that a woman’s body is best suited for conception and childbearing during the 20s and early 30s. As Jessica Brown of American Baby explains, “In 1970, American women typically had their first child at 21–today, most of us are just shy of 25 on the big day. And as you’ve likely heard, the younger you are, the smoother your pregnancy will be.” Jennifer N. Niebyl, M.D., professor and head of the Department of Obstetrics and Gynecology at the University of Iowa Hospitals and Clinic, went on to assert that this is because a younger woman’s eggs are young and more likely to be healthy. This means a much lower risk of birth defects and a much greater chance of a successful pregnancy.

According to the National Center for Health Statistics, birth rates for women between the ages of 35 to 39 doubled between 1978 and 2000. Though the risk of complications and greater fatigue rise once a woman enters her late 30s, births to women in their 40s are now considered common, though some may be classified at higher risk. By age 42, the risk of miscarriage stands at more than 50 percent. The risk of chromosomal defects also rises significantly once a woman enters her 40s.

Of course, Ms. Iliescu sought to go around this problem with the use of IVF technology. Her doctors used eggs and sperm from young donors and, with the use of hormonal drugs, doctors were able to trick Ms. Iliescu’s body into responding with the effects of pregnancy.

To some observers, this is simply a matter of reproductive autonomy. “Reproductive rights or reproductive autonomy has a pretty strong precedent in this country,” argued Richard Paulson, director of the University of Southern California’s fertility clinic. “You don’t have to be pregnant if you don’t want to. Conversely, if you cannot be pregnant, we will help you.”

This projection of “reproductive autonomy” is a logical extension of the ethos of sexual liberation and personal autonomy that has transformed America since the 1960s. Nevertheless, we can legitimately object that the assertion of a dubious “right” to reproduction bears only slightly, if at all, on a case dealing with a 66-year-old woman who had to use donor gametes and extensive technology in order to achieve a pregnancy which produced a child that is not genetically her own.

The Romanian Orthodox Church appeared puzzled by the case. The press office of Patriarch Bogdan Teleanu first responded with a statement that seemed to celebrate the birth: “The Bible preaches love and procreation at whatever age.” As further details became clear, the church clarified its position with a comprehensive denunciation of the IVF technology. “The technique used by this woman runs counter to Christian morality,” asserted Bishop Ciprian Campineanul. “Life is a gift of God and a child is the fruit of a love relationship between a man and a woman. I daresay the desire of this woman to have a child at the age of 67 shows her selfishness. The Orthodox Church encourages couples to resort to adoption rather than to in-vitro fertilization.”

Putting Ms. Iliescu’s unmarried state and the use of IVF technology aside, we are still left with the reality that a 66- (about to turn 67-) year-old woman has now given birth to a baby she may never have the opportunity to raise. While some have defended her, arguing that this factor is unimportant, the stubborn fact of this age difference remains. Throughout history, many courageous and committed grandmothers have proved that older women can indeed bear the responsibilities of changing diapers and taking care of infant needs. Nevertheless, this is still far from a realistic expectation that Ms. Iliescu will be able to teach her daughter to ride a bicycle, take her to ballet lessons, see her graduate from high school, and help her reach full adulthood.

Our society’s headlong push to affirm virtually any personal choice as protected by a right to personal autonomy is now assisted by technologies that allow us to vault over natural barriers and attempt to redefine the human species. Christians must be concerned about this development at many levels, and the case of Adriana Iliescu raises a host of complexities and difficult issues. We must certainly pray that little Eliza Maria will gain weight, be able to leave the hospital, and grow into a healthy childhood. We must also hope that Ms. Iliescu will be given extraordinary strength and stamina in order to fulfill her new responsibilities as a mother. Beyond this, we must provide leadership in defining the critical issues at stake and helping to forge a medical ethic that will truly honor human life, human dignity, and human responsibility.

Oddly enough, this report also reminds us that Adriana Iliescu is not likely to remain the world’s oldest mother very long. Just a few years ago, the oldest mother was an Indian woman who gave birth at 65. The last edition of the Guinness Book of World Records lists two 63-year-old women as oldest mothers. What’s next?